Browsing by Subject "Glycaemic control"

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  • Harris, Stewart B.; Parente, Erika B.; Karalliedde, Janaka (2022)
    Type 2 diabetes (T2D) is a progressive disease, with many individuals eventually requiring basal insulin therapy to maintain glycaemic control. However, there exists considerable therapeutic inertia to the prompt initiation and optimal titration of basal insulin therapy due to barriers that include fear of injections, hypoglycaemia, weight gain, and burdensome regimens. Hypoglycaemia is thought to be a major barrier to optimal glycaemic control and is associated with significant morbidity and mortality. Newer second-generation basal insulin analogues provide comparable glycaemic control with lower risk of hypoglycaemia compared with first-generation basal insulin analogues. The present review article discusses clinical evidence for one such second-generation basal insulin analogue, insulin glargine 300 U/mL (Gla-300), in the context of hypothetical case studies that are representative of individuals who may attend routine clinical practice. These case studies discuss individualised treatment needs for people with T2D who are insulin-naive or pre-treated. Clinical characteristics such as older age, frequent nocturnal hypoglycaemia, and renal impairment, which are known risk factors for hypoglycaemia, are also considered.
  • The FinnDiane Study Group; Ahola, Aila J.; Forsblom, Carol; Harjutsalo, Valma; Groop, Per-Henrik (2019)
    Aims Low-carbohydrate diet (LCD) has gained interest among individuals with diabetes as a means to manage glycaemia. We investigated the adherence to LCD in the Finnish Diabetic Nephropathy Study and whether carbohydrate restriction is associated with cardio-metabolic risk factors. Methods Cross-sectional data were available from 902 individuals with type 1 diabetes (44% men, age 47±13 years). Dietary data were collected twice with a 3-day diet record. Mean of the measurements was used. Carbohydrate intake 253 g/day or >48 E%). In the whole population, carbohydrate-to-fat ratio was calculated and its association with health variables was investigated. Results Higher carbohydrate-to-fat ratio was associated with higher blood glucose variability, higher blood pressure, lower HDL cholesterol concentration, and in men with lower waist-to-hip ratio. LCD adherence (n=69) was associated with lower BMI (25.6 vs. 27.8 kg/m2, p=0.030), lower variability of blood glucose measurements (0.38 vs. 0.45 mmol/l, p=0.030), and lower diastolic blood pressure (74 vs. 79 mmHg, p=0.048). Men reporting LCD had higher total (5.1 vs. 4.0 mmol/l, p=0.007) and non-HDL cholesterol (3.4 vs. 2.7 mmol/l, p=0.021). Women with LCD had higher HDL-cholesterol concentration (1.9 vs. 1.5 mmol/l, p=0.014). Conclusions Reduced blood glucose variability, related to LCD, could have clinical relevance to individuals with type 1 diabetes.